Prostate cancer: to screen or not to screen?

Prostate cancer: to screen or not to screen?

With prostate cancer as one of the commonest types of cancer affecting men, a lot of thought has gone into researching how one might detect the disease as early as possible. The topic of screening tests in prostate cancer is very controversial and there has been much debate about whether or not men should be having routine screening tests – here is what you need to know.

When should I consider screening?

Depending on how high your risk is for prostate cancer (click here for information on risk factors ), you need to start discussing the need for screening tests with your healthcare professional from the age of 40. Your healthcare professional will tell you what is suitable depending on your risk factors.

What are the screening tests?

There are two main types of screening tests used for detecting prostate cancer:

• Digital Rectal Examination: A gloved finger is placed into your rectum to examine your prostate, which is next to the rectum. Lubrication is used to minimise discomfort. If any abnormalities are found, more tests may be needed.
• Blood testing for Prostate Specific Antigens (PSA): Blood is drawn from your arm and sent away to a laboratory to be tested for PSA, a substance that’s produced by your prostate gland. If the level of PSA is higher than normal, it may indicate prostate infection, inflammation, enlargement or cancer.

Large research studies show that screening with the PSA test or with both the PSA and rectal examination will detect prostate cancer earlier than if you do not do any screening, so this is the main benefit of screening.

What’s the debate about then?

Whether or not early detection reduces your risk of actually dying from prostate cancer is still unclear, with research finding conflicting results and experts unable to reach consensus. Research has found that while some men benefit from getting treatment early on in the disease, others may likely have died from other causes before the prostate cancer became bad enough to cause them health problems. This conundrum is made worse by the fact the treatment of prostate cancer is not without its own risks: depending on the treatment given, treatment can cause urinary, bowel, sexual and other health problems. These problems range from mild to severe and may be permanent or temporary. The good news is that if you do screen positive on the PSA test, you may not need immediate treatment and your healthcare professional may opt for regular blood tests and biopsies to assess the need for treatment in the future.

So what do I do?

First of all, you need to assess your risk factors for prostate cancer by discussing them with your healthcare professional. Once you know how at risk you are you will be in a better position to decide if you want the tests or not. For those who want to avoid cancer at all costs, screening is the way to go, but for those wanting to avoid the possible harms of screening or treatment, discuss the pros and cons with your health care provider to make the best decision for you.

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